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Care Manager, BH - Remote in PA

Magellan Health

Belém

Híbrido

USD 58.000 - 94.000

Tempo integral

Há 30+ dias

Melhora as tuas possibilidades de ir a entrevistas

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Resumo da oferta

An established industry player is seeking a Care Manager to oversee mental health and substance abuse services. This role involves authorizing and reviewing care, developing discharge plans, and ensuring effective treatment for members. The ideal candidate will possess strong organizational and communication skills, along with relevant licensure and experience in healthcare settings. Join a forward-thinking organization that values quality improvement and patient advocacy, while offering a comprehensive benefits package to enhance your well-being and career growth.

Serviços

Health Insurance
Life Insurance
Flexible Work Hours
Employee Assistance Program
Professional Development Opportunities

Qualificações

  • Minimum 2 years of experience in healthcare or behavioral health.
  • Licensure required: CEAP, LCSW, LMSW, LPC, RN, etc.

Responsabilidades

  • Authorizes and reviews mental health and substance abuse services.
  • Develops discharge plans and oversees their implementation.
  • Participates in quality improvement activities.

Conhecimentos

Organization Skills
Time Management
Communication Skills
Utilization Management Procedures
Analytical Skills

Formação académica

Associate Degree in Nursing
Bachelor's Degree in Social Work
Master's Degree in Social Work

Descrição da oferta de emprego

Under general supervision, and in collaboration with other members of the clinical team, authorizes and reviews utilization of mental health and substance abuse services provided in inpatient and/or outpatient care settings. Collects and analyzes utilization data. Assists with discharge planning and care coordination. Provides member assistance with mental health and substance abuse issues, and participates in special quality improvement projects.

  • Monitors inpatient and/or outpatient level of care services related to mental health and substance abuse treatment to ensure medical necessity and effectiveness.
  • Provides telephone triage, crisis intervention and emergency authorizations as assigned.
  • Performs concurrent reviews for inpatient and/or outpatient care and other levels of care as allowed by scope of practice and experience.
  • In conjunction with providers and facilities, develops discharge plans and oversee their implementation.
  • Performs quality clinical reviews while educating and making appropriate interventions to advance the care of the member in treatment.
  • Provides information to members and providers regarding mental health and substance abuse benefits, community treatment resources, mental health managed care programs, and company policies and procedures, and criteria.
  • Interacts with Physician Advisors to discuss clinical and authorization questions and concerns regarding specific cases.
  • Participates in quality improvement activities, including data collection, tracking, and analysis.
  • Maintains an active work load in accordance with National Care Manager performance standards.
  • Works with community agencies as appropriate. Proposes alternative plans of treatment when requests for services do not meet medical necessity criteria.
  • Participates in network development including identification and recruitment of quality providers as needed.
  • Advocates for the patient to ensure treatment needs are met. Interacts with providers in a professional, respectful manner that facilitates the treatment process.
Other Job Requirements

Licensure is required for this position, specifically a current license that meets State, Commonwealth or customer-specific requirements.

One or more of the following licensure is required for this role with necessary degrees: CEAP, LMSW, LCSW, LSW, LPC or RN.

Minimum 2 years experience post degree in healthcare, behavioral health, psychiatric and/or substance abuse health care setting.

Strong organization, time management and communication skills.

Knowledge of utilization management procedures, mental health and substance abuse community resources and providers.

Knowledge and experience in inpatient and/or outpatient setting.

Knowledge of DSM V or most current diagnostic edition.

Ability to analyze specific utilization problems, plan and implement solutions that directly influence quality of care.

General Job Information

Title: Care Manager, BH - Remote in PA

Grade: 24

Work Experience - Required: Clinical

Work Experience - Preferred: N/A

Education - Required: Associate - Nursing, Bachelor's - Social Work, Master's - Social Work

Education - Preferred: N/A

License and Certifications - Required: CEAP - Certified Employee Assistance Professional - Care Mgmt, LCSW - Licensed Clinical Social Worker - Care Mgmt, LMFT - Licensed Marital and Family Therapist - Care Mgmt, LMSW - Licensed Master Social Worker - Care Mgmt, LPC - Licensed Professional Counselor - Care Mgmt, LSW - Licensed Social Worker - Care Mgmt, RN - Registered Nurse, State and/or Compact State Licensure - Care Mgmt

License And Certifications - Preferred: N/A

Salary Range:

Salary Minimum: $58,440

Salary Maximum: $93,500

This information reflects the anticipated base salary range for this position based on current national data. Minimums and maximums may vary based on location. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law.

This position may be eligible for short-term incentives as well as a comprehensive benefits package. Magellan offers a broad range of health, life, voluntary and other benefits and perks that enhance your physical, mental, emotional and financial wellbeing.

Magellan Health, Inc. is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled.

Every employee must understand, comply with and attest to the security responsibilities and security controls unique to their position; and comply with all applicable legal, regulatory, and contractual requirements and internal policies and procedures.

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